Social, Genetics and Histopathological Factors Related to Titin (TTN) Gene Mutation and Survival in Women with Ovarian Serous Cystadenocarcinoma: Bioinformatics Analysis.

Several factors may increase the risk of development of ovarian cancer. In this study, we investigated the relationship between social, genetic, and histopathologic factors in women with ovarian serous cystadenocarcinoma and titin (TTN) mutations, whether the TTN gene mutation may be a predictor, and its impact on mortality and survival in these patients. A total of 585 samples from patients with ovarian serous cystadenocarcinoma were collected from The Cancer Genome Atlas and PanCancer Atlas through the cBioPortal for analysis of social, genetic, and histopathological factors. Logistic regression was used to investigate whether TTN mutation could be a predictor, and the Kaplan-Meier method was applied to analyze survival time. TTN mutation frequency did not differ between age at diagnosis, tumor stage, and race, and was related to increased Buffa hypoxia score (p = 0.004), mutation count (p < 0.0001), Winter hypoxia Score (p = 0.030), nonsynonymous tumor mutation burden (TMB) (p < 0.0001), and reduced microsatellite instability sensor score (p = 0.010). The number of mutations (p < 0.0001) and winter hypoxia score (p = 0.008) were positively associated with TTN mutations, and nonsynonymous TMB (p < 0.0001) proved to be a predictor. Mutated TTN affects the score of genetic variables involved in cancer cell metabolism in ovarian cystadenocarcinoma.

Malaria and environmental, socioeconomics and public health conditions in the municipality of São Félix do Xingu, Pará, Eastern Amazon, Brazil: An ecological and cross-sectional study.

BACKGROUND: Malaria is a parasitosis conditioned by several factors. This study sought to analyze the spatial distribution of malaria considering environmental, socioeconomic, and political variables in São Félix do Xingu, Pará, Brazil, from 2014 to 2020. METHODS: Epidemiological, cartographic, and environmental data were obtained from the Ministry of Health, Brazilian Geographical and Statistical Institute, and National Space Research Institute. Statistical and spatial distribution analyses were performed using chi-squared tests of expected equal proportions and the kernel and bivariate global Moran's techniques with Bioestat 5.0 and ArcGIS 10.5.1. RESULTS: The highest percentage of cases occurred in adult males with brown skin color, mainly placer miners, with a primary education level, living in rural areas, who were infected with Plasmodium vivax and with parasitemia of two or three crosses as diagnosed by the thick drop/smear test. The disease had a non-homogeneous distribution, with distinct annual parasite indices associated with administrative districts and clusters of cases in locations with deforestation, mining, and pastures close to Conservation Units and Indigenous Lands. Thus, a direct relationship between areas with cases and environmental degradation associated with land use was demonstrated, along with the precarious availability of health services. Pressure on protected areas and epidemiological silence in Indigenous Lands were also noted. CONCLUSIONS: Environmental and socioeconomic circuits were identified for development of diseases associated with precarious health services in the municipality. These findings highlight the need to intensify malaria surveillance and contribute to the systematic knowledge of malaria's epidemiology by considering the complexity of its conditioning factors.

COVID-19 in the Eastern Brazilian Amazon: Incidence, Clinical Management, and Mortality by Social Determinants of Health, Symptomatology, and Comorbidities in the Xingu Health Region.

This study aims to investigate the relationship between social determinants of health (SDH), incidence, and mortality to verify which sociodemographic factors, symptoms, and comorbidities predict clinical management; second, this study aims to conduct a survival analysis of individuals with COVID-19 in the Xingu Health Region. Consequently, this study adopted an ecological framework, employing secondary data of COVID-19-positive individuals from the Xingu Health Region, Pará State, Brazil. The data were obtained through the database of the State of Pará Public Health Secretary (SESPA) for the period from March 2020 to March 2021. The incidence and mortality were higher in Vitória do Xingu and Altamira. Municipalities with a higher percentage of citizens with health insurance and higher public health expenditure showed a higher incidence and mortality. A higher gross domestic product was associated with a higher incidence. Females were found to be associated with better clinical management. To live in Altamira was a risk factor for intensive care unit admission. The symptoms and comorbidities that predicted worse clinical management were dyspnea, fever, emesis, chills, diabetes, cardiac and renal diseases, obesity, and neurological diseases. There were higher incidence, mortality, and lower survival rates among the elderly. Thus, it can be concluded that SDH indicators, symptomatology, and comorbidities have implications for the incidence, mortality, and clinical management of COVID-19 in the Xingu Health Region of eastern Amazonia, Brazil.

Amazon Amandaba-Prevalence, Risk Factors and Self-Care Perception Associated with Diabetic Peripheral Neuropathy in Patients with Type 2 Diabetes: A Cross-Sectional Study.

BACKGROUND: Diabetic peripheral neuropathy (DPN) is one of the most common complications of type 2 diabetes mellitus. There is a gradual loss of protective sensation in the skin and the function of the foot joints, increasing the risk of injury as the disease progresses. The objective of this study was to verify whether socioeconomic factors, health risk factors, and self-care are associated with DPN. METHODS: Observational cross-sectional with 228 individuals of ≥30 years in Family Health Strategies in a city in the eastern Amazon, in northern Brazil, using questionnaires containing socioeconomic information, clinical and laboratory parameters, the Summary of Diabetes Self-Care Activities Questionnaire, and the Michigan Neuropathy Screening Instrument. RESULTS: The prevalence of DPN was 66.6%. The presence of neuropathy is associated with male gender, dyslipidemia, and increased microalbuminuria. Logistic regression analysis revealed male subjects' increased BMI and altered HDL levels were associated with DPN. CONCLUSIONS: In men with altered BMI, and dysregulation in biochemical parameters, neuropathy is more prevalent.

Amazon Amandaba-Sociodemographic Factors, Health Literacy, Biochemical Parameters and Self-Care as Predictors in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study.

BACKGROUND: Health literacy (HL) and its domains (functional, critical, and communicative) appear to be related to self-care adherence in people with type 2 diabetes mellitus (DM2). This study aimed to verify if sociodemographic variables are predictors of HL, if HL and the sociodemographic factors affect biochemical parameters together, and if HL domains are predictors of self-care in DM2. METHODS: We used the baseline assessment data from 199 participants ≥ 30 years in the project, "Amandaba na Amazônia: Culture Circles as a Strategy to Encourage Self-care for DM in Primary Health Care," which took place in November and December 2021. RESULTS: In the HL predictor analysis, women (p = 0.024) and higher education (p = 0.005) were predictors of better functional HL. The predictors of biochemical parameters were: glycated hemoglobin control with low critical HL (p = 0.008); total cholesterol control with female sex (p = 0.004), and low critical HL (p = 0.024); low-density lipoprotein control with female sex (p = 0.027), and low critical HL (p = 0.007); high-density lipoprotein control with female sex (p = 0.001); triglyceride control with low Functional HL (p = 0.039); high levels of microalbuminuria with female sex (p = 0.014). A low critical HL was a predictor of a lower specific diet (p = 0.002) and a low total HL of low medication care (p = 0.027) in analyses of HL domains as predictors of self-care. CONCLUSION: Sociodemographic factors can be used to predict HL, and HL can predict biochemical parameters and self-care.

Malaria and environmental, socioeconomics and public health conditions in the municipality of São Félix do Xingu, Pará, Eastern Amazon, Brazil: An ecological and cross-sectional study

ABSTRACT Background: Malaria is a parasitosis conditioned by several factors. This study sought to analyze the spatial distribution of malaria considering environmental, socioeconomic, and political variables in São Félix do Xingu, Pará, Brazil, from 2014 to 2020. Methods: Epidemiological, cartographic, and environmental data were obtained from the Ministry of Health, Brazilian Geographical and Statistical Institute, and National Space Research Institute. Statistical and spatial distribution analyses were performed using chi-squared tests of expected equal proportions and the kernel and bivariate global Moran's techniques with Bioestat 5.0 and ArcGIS 10.5.1. Results: The highest percentage of cases occurred in adult males with brown skin color, mainly placer miners, with a primary education level, living in rural areas, who were infected with Plasmodium vivax and with parasitemia of two or three crosses as diagnosed by the thick drop/smear test. The disease had a non-homogeneous distribution, with distinct annual parasite indices associated with administrative districts and clusters of cases in locations with deforestation, mining, and pastures close to Conservation Units and Indigenous Lands. Thus, a direct relationship between areas with cases and environmental degradation associated with land use was demonstrated, along with the precarious availability of health services. Pressure on protected areas and epidemiological silence in Indigenous Lands were also noted. Conclusions: Environmental and socioeconomic circuits were identified for development of diseases associated with precarious health services in the municipality. These findings highlight the need to intensify malaria surveillance and contribute to the systematic knowledge of malaria's epidemiology by considering the complexity of its conditioning factors.

Association between Sociodemographic Factors, Coverage and Offer of Health Services with Mortality Due to Oral and Oropharyngeal Cancer in Brazil: A 20-Year Analysis.

To investigate the association between sociodemographic factors and variables related to oral health services in oral and oropharyngeal cancer mortality in Brazil, between 2000 and 2019. This study had an ecological design. Standardized mortality rates were compared between age group, sex, and regions. Age-Period-Cohort analysis was applied. Oral health services variables were analyzed in correlation tests. Survival analysis included Kaplan-Meier estimators, log-rank tests, and Cox regression. The mortality rate increased with age and was higher in men. Southeast and south regions had the highest rates for men, and the northeast and southeast had it for women. Age-Period-Cohort analysis showed a slight increase in female deaths and an increasing trend in the annual percent change in mortality for men over age 55. In survival analysis, males, Black individuals and southern residents were more strongly associated with death. The correlation between oral health teams' coverage was high and negative, while the number of dental specialty centers and soft tissue biopsies had a high and positive correlation. Mortality and survival patterns were dependent on sex, age, geographic region and race/ethnicity. It was observed that preventive and diagnostic procedures were not being performed, which may be related to the increase in mortality.

Vitamin D3 supplementation may attenuate morphological and molecular abnormalities of the olfactory bulb in a mouse model of Down syndrome.

Individuals with Down syndrome (DS) exhibit impaired olfactory function and are at a higher risk of developing Alzheimer's disease (AD). Olfactory dysfunction may be an early clinical symptom of AD. Recent studies have demonstrated that vitamin D3 (VD3) exerts neuroprotective effects in mouse models of AD. In this study, we investigated the effects of VD3 on the morphology, immunolocalization, and markers involved in neuropathogenic processes, apoptosis, proliferation, cell survival, and clearance of amyloid peptides, along with neuronal markers in the olfactory bulb (OB) of an adult female mouse model of DS. Morphological and molecular analyses revealed that trisomic mice exhibited a volume reduction in the external plexiform layer, a decrease in the number of mitral and granule cells, and an increase in the expression of amyloid-ß 42, caspase-3 p12, and P-glycoprotein. VD3 reversed certain morphological abnormalities in the OB of control trisomic mice (Ts(CO)) and decreased the levels of caspase-3 p12 and methylenetetrahydrofolate reductase in the treated groups. The results demonstrated that trisomy factor causes morphofunctional abnormalities in the OB of Ts(CO) mice. Moreover, VD3 could represent a therapeutic target to attenuate morphological and molecular alterations in OB.

Fatores de prevenção de distúrbios osteomusculares relacionados ao trabalho: revisão narrativa / Preventive factors against work-related musculoskeletal disorders: narrative review

Os distúrbios osteomusculares (DOM) representam as principais causas de morbidade nos trabalhadores. Estes distúrbios podem ser entendidos como um conjunto de sinais e sintomas relacionados ao trabalho, tais como dor, parestesia, fadiga e limitação da amplitude de movimento. Estas disfunções são devidas a fatores biomecânicos, sociais, psicológicos e físicos no ambiente de trabalho. Os principais fatores cinéticos funcionais associados a essas lesões são: movimentos repetitivos, força excessiva, postura inadequada, compressão e vibração mecânica das articulações. Nesse contexto, o conhecimento das características epidemiológicas, das ferramentas para avaliação do risco ergonômico e da sintomatologia osteomuscular e a realização de ginástica laboral podem contribuir para reduzir a ocorrência dos DOM. Assim, a proposta da presente revisão é demonstrar a aplicabilidade de estratégias para a prevenção dos DOM nos trabalhadores. A revisão narrativa foi realizada a partir de um levantamento nas bases de dados PubMed e BIREME. Foram incluídos estudos publicados em inglês, espanhol ou português. A prática de exercício promove benefícios tanto para as organizações quanto para os trabalhadores. As ferramentas para análise de risco de DOM são importantes para a identificação precoce dos riscos no trabalho e assim evitar consequências negativas para a saúde e os custos gerados pelo afastamento dos trabalhadores.

Musculoskeletal disorders (MSDs) are major causes of morbidity among workers. They comprise several signs and symptoms, as e.g. pain, paresthesia, fatigue and limited range of motion, which can be related to work tasks. Workplace-related factors include physical, psychological, social and biomechanical hazards. The main kinetic factors associated with MSDs include repetitive movements, exerting excessive force, awkward postures, compression and mechanical vibration. Accurate knowledge of epidemiological aspects, evaluation of ergonomic hazards and musculoskeletal symptoms, and workplace exercise may help reduce the occurrence of MSDs. The aim of the present review is to analyze the applicability of preventive strategies against MSDs among workers. We performed a narrative review based on a survey of databases PubMed and BIREME and included studies published in English, Spanish or Portuguese. We found that workplace exercise is beneficial for both employers and workers. Risk analysis of MSDs is essential for early identification of occupational hazards and to prevent health consequences and costs associated with absenteeism.

Characteristics and clinical aspects of patients with spinal cord injury undergoing surgery.

OBJECTIVE: To identify the characteristics of patients with spinal cord injury (SCI) undergoing surgery. METHODS: Previously, 321 patients with SCI were selected. Clinical and socio-demographic variables were collected. RESULTS: A total of 211 patients were submitted to surgery. Fall and injuries in the upper cervical and lumbosacral regions were associated with conservative treatment. Patients with lesions in the lower cervical spine, worse neurological status, and unstable injuries were associated with surgery. Individuals undergoing surgery were associated with complications after treatment. The authors assessed whether age influenced the characteristics of patients submitted to surgery. Subjects with <60 years of age were associated with motorcycle accidents and the morphologies of injury were fracture-dislocation. Elderly individuals were associated to fall, SCI in the lower cervical spine and the morphology of injury was listhesis. Subsequently, the authors analyzed the gender characteristics in these patients. Women who suffered car accidents were associated to surgery. Women were associated with paraparesis and the morphologic diagnosis was fracture-explosion, especially in the thoracolumbar transition and lumbosacral regions. Men who presented traumatic brain injury and thoracic trauma were related to surgery. These individuals had a worse neurological status and were associated to complications. Men and the cervical region were most affected, thereby, these subjects were analyzed separately (n = 92). The presence of complications increased the length of hospital stay. The simultaneous presence of morphological diagnosis, worst neurological status, tetraplegia, sensory, and motor alterations were associated with complications. Pneumonia and chest trauma were associated with mortality. CONCLUSION: These factors enable investments in prevention, rehabilitation, and treatment.

OBJETIVO: Identificar as características de pacientes com traumatismo raquimedular (TRM) submetidos à cirurgia. MÉTODOS: Previamente, 321 pacientes com TRM foram selecionados. As variáveis clínicas e sócio-demográficas foram coletadas. RESULTADOS: Um total de 211 pacientes foram submetidos a cirurgia. A queda e lesões nas regiões cervical superior e lombosacral foram associadas com tratamento conservador. Pacientes com lesões nas regiões cervical inferior, pior status neurológico e lesões instáveis foram associados com cirurgia. Indivíduos operados foram associados com complicações após tratamento. Posteriormente, os autores avaliaram se idade influenciava as características dos pacientes submetidos à cirurgia. Sujeitos com < 60 anos foram associados com acidente motociclístico e o diagnóstico de fratura-luxação. Subsequentemente, analisaram-se as características dos sexos nestes pacientes. Mulheres que sofreram acidente automobilístico foram associadas com cirurgia. Mulheres foram associadas com paraparesia e diagnóstico morfológico de fratura explosão, principalmente nas regiões de transição tóraco-lombar e lombo-sacral. Homens que apresentaram traumatismo crânio-encefálico e torácico foram relacionados a cirurgia. Estes indivíduos tiveram um pior status neurológico e foram associados à complicação. Homens e região cervical foram mais afetadas; portanto, estes pacientes foram analisados isoladamente (n = 92). A presença de complicações aumentou a permanência hospitalar. A presença de diagnósticos morfológicos simultaneamente, pior status neurológico, tetraplegia, alteração sensório-motora foram associados com complicações. Pneumonia e traumatismo torácico foram associados com mortalidade. CONCLUSÃO: Estes fatores possibilitam investimentos em prevenção, reabilitação e tratamento.

Characteristics and clinical aspects of patients with spinal cord injury undergoing surgery / Caracterização e aspectos clínicos de pacientes com traumatismo raquimedular submetidos a cirurgia

ABSTRACT OBJECTIVE: To identify the characteristics of patients with spinal cord injury (SCI) undergoing surgery. METHODS: Previously, 321 patients with SCI were selected. Clinical and socio-demographic variables were collected. RESULTS: A total of 211 patients were submitted to surgery. Fall and injuries in the upper cervical and lumbosacral regions were associated with conservative treatment. Patients with lesions in the lower cervical spine, worse neurological status, and unstable injuries were associated with surgery. Individuals undergoing surgery were associated with complications after treatment. The authors assessed whether age influenced the characteristics of patients submitted to surgery. Subjects with <60 years of age were associated with motorcycle accidents and the morphologies of injury were fracture-dislocation. Elderly individuals were associated to fall, SCI in the lower cervical spine and the morphology of injury was listhesis. Subsequently, the authors analyzed the gender characteristics in these patients. Women who suffered car accidents were associated to surgery. Women were associated with paraparesis and the morphologic diagnosis was fracture-explosion, especially in the thoracolumbar transition and lumbosacral regions. Men who presented traumatic brain injury and thoracic trauma were related to surgery. These individuals had a worse neurological status and were associated to complications. Men and the cervical region were most affected, thereby, these subjects were analyzed separately (n= 92). The presence of complications increased the length of hospital stay. The simultaneous presence of morphological diagnosis, worst neurological status, tetraplegia, sensory, and motor alterations were associated with complications. Pneumonia and chest trauma were associated with mortality. CONCLUSION: These factors enable investments in prevention, rehabilitation, and treatment.

RESUMO OBJETIVO: Identificar as características de pacientes com traumatismo raquimedular (TRM) submetidos a cirurgia. MÉTODOS: Foram selecionados 321 pacientes com TRM. As variáveis clínicas e sociodemográficas foram coletadas. RESULTADOS: Foram submetidos a cirurgia 211 pacientes. A queda e as lesões nas regiões cervical superior e lombossacral foram associadas com tratamento conservador. Pacientes com lesões nas regiões cervical inferior, pior status neurológico e lesões instáveis foram associados com cirurgia. Indivíduos operados foram associados com complicações após tratamento. Posteriormente, os autores avaliaram se idade influenciava as características dos pacientes submetidos a cirurgia. Sujeitos com < 60 anos foram associados com acidente motociclístico e o diagnóstico de fratura-luxação. Subsequentemente, analisaram-se as características dos sexos nesses pacientes. Mulheres que sofreram acidente automobilístico foram associadas com cirurgia. Mulheres foram associadas com paraparesia e diagnóstico morfológico de fratura explosão, principalmente nas regiões de transição toracolombar e lombossacral. Homens que apresentaram traumatismo crânioencefálico e torácico foram relacionados a cirurgia. Esses indivíduos tiveram um pior status neurológico e foram associados à complicação. Homens e região cervical foram mais afetados; portanto, esses pacientes foram analisados isoladamente (n = 92). A presença de complicações aumentou a permanência hospitalar. A presença de diagnósticos morfológicos simultaneamente, pior status neurológico, tetraplegia, alteração sensório-motora foi associada com complicações. Pneumonia e traumatismo torácico foram associados com mortalidade. CONCLUSÃO: Esses fatores possibilitam investimentos em prevenção, reabilitação e tratamento.

Muscular pressure pain threshold and influence of craniocervical posture in individuals with episodic tension-type headache / Limiar de dor muscular à pressão e influência da postura craniocervical em indivíduos com cefaleia tensional episódica / Umbral del dolor muscular por presión e influencia de la postura craneocervical en sujetos con cefalea de tipo tensional episódica

ABSTRACT Objective: The objective of this study was to analyze the pressure pain threshold (PPT) of the sternocleidomastoid (SCM), suboccipital (SO) and upper trapezius (UT) muscles and the craniocervical posture in individuals with episodic tension-type headache (ETTH). Methods: This study was a cross-sectional, non-randomized study with 60 young adults (77% female) comprising both sexes and an age range of 18-27 years. Individuals were distributed into a control group (G1) and individuals with ETTH (G2). The frequency of headaches per month was recorded. A pressure dynamometer was used to evaluate the PPT. Photogrammetry was used to evaluate the cervical lordosis (CL) and cephalic protrusion (CP). The data were statistically analyzed. Results: There were differences in the PPT, where the UT, SO and SCM muscles presented lower sensitivity to pain, respectively. The SCM muscle presented a lower PPT in G2. The CL and CP angles were significantly lower in G2. Conclusion: Individuals with ETTH exhibited a significantly lower PPT in the SCM and SO muscles than in the UT muscle. Nevertheless, individuals with ETTH presented with the SCM muscle being more sensitive to pain as well as higher CL and CP than individuals without symptomatology.

RESUMO Objetivo: Analisar o limiar de dor por pressão (LDP) nos músculos esternocleidomastóideo (ECM), suboccipital (SO) e trapézio superior (TS) e o posicionamento craniocervical em indivíduos com cefaleia do tipo tensional episódica (CTTE). Métodos: Estudo transversal, não randomizado com 60 adultos jovens (77% mulheres), faixa etária entre 18 e 27 anos. Os indivíduos foram distribuídos em um grupo controle (G1) e um com CTTE (G2). A frequência de dores de cabeça por mês foi coletada. Para a avaliação do LDP foi utilizado dinamômetro de pressão. Para avaliação da lordose cervical (LC) e protrusão cefálica (PC) foi utilizada a fotogrametria. Os dados foram submetidos à análise estatística. Resultados: Houve diferenças no LDP, sendo que os músculos trapézio superior (TS), suboccipital (SO) e esternocleidomastóideo (ECM) apresentaram, nessa ordem, menor sensibilidade à dor. O músculo ECM apresentou menor LDP no G2. Os ângulos de lordose cervical e protrusão cefálica foram significativamente menores no G2. Conclusão: Indivíduos com CTTE apresentam LDP significativamente menor nos músculos ECM e SO, nessa ordem, em comparação ao TS e indivíduos com CTTE têm músculo ECM mais sensível à dor, maior lordose cervical e protrusão cefálica do que indivíduos sem sintomas.

RESUMEN Objetivo: Analizar el umbral de dolor por presión (UDP) de los músculos esternocleidomastoideo (ECM), suboccipital (SO) y trapecio superior (TS) y el posicionamiento craneocervical en individuos con cefalea de tipo tensional episódica (CTTE). Métodos: Estudio transversal, no aleatorizado de 60 adultos jóvenes (77% mujeres), grupo etario entre 18 e 27 años. Los individuos fueron divididos en un grupo control (G1) y otro con CTTE (G2). Se recolectó la frecuencia de los dolores de cabeza por mes. Para la evaluación del UDP fue utilizado un dinamómetro de presión y para evaluar la lordosis cervical (LC) y la protrusión cefálica (PC) se utilizó la fotogrametría. Los datos fueron sometidos a análisis estadístico. Resultados: Hubo diferencias en el UDP, y los músculos trapecio superior (TS), suboccipital (SO) y esternocleidomastoideo (ECM) mostraron, en ese orden, menor sensibilidad al dolor. El músculo ECM mostró menor UDP en el G2. Los ángulos de lordosis cervical y de protrusión cefálica fueron significativamente menores en el G2. Conclusión: Los individuos con CTTE presentan UDP significativamente menor en los músculos ECM y SO, en ese orden en comparación al TS e individuos con CTTE tienen el músculo ECM más sensible al dolor, mayor lordosis cervical y protrusión cefálica que individuos sin síntomas.

Profile of Pneumopathic Elderly Persons Admitted to a Pulmonary Rehabilitation Center / Perfil de idosos pneumopatas admitidos em centro de reabilitação pulmonar

Abstract Introduction: Pneumopathies are defined as a group of respiratory diseases. Physiotherapy centers are a conventional treatment option which can help prevent and treat various pulmonary conditions. Objective: To characterize elderly persons with pneumopathies admitted for pulmonary rehabilitation. Methods: 84 elderly persons were admitted for pulmonary rehabilitation. Patients diagnosed with pulmonary disease and aged ≥60 years were included in the study. The following variables were analyzed: gender, age, marital status, profession, medical diagnosis, main medical complaint, associated diseases, and cardiovascular risk factors. Results: The most common lung disease is chronic obstructive pulmonary disease (COPD) (26.2%). Women showed a greater association with asthma [odds ratio (OR)=5.875; p=0.010]. Dyspnea was the most prevalent main complaint among this population (50%). Among the main complaints, difficulty walking was more associated with men (OR=2.85; p=0.055). Strokes were the main disease most commonly associated with pneumopathies (12.1%). Women had a greater association with other diseases (OR=5.34, p=0.068), especially when two diseases were presented simultaneously with lung disease (OR=2.32, p=0.041). Among the risk factors, physical inactivity (OR=3.33), alcohol consumption (OR=0.046) and history of smoking (OR=3.00) were significantly associated with men, while depression (OR=5.67) was significantly associated with women. Women exhibited a 3.28 greater association between allergies and pneumopathies than men (p=0.013). The practice of physical activity was more associated with women (OR=3.89; p=0.03). Osteoporosis was more prevalent among elderly women with pulmonary disease (OR=10.75; p<0.0001), and was also significantly associated with a history of smoking (OR=4.31; p=0.009). Conclusion: The most frequent diagnosis, main complaint and associated disease were COPD, dyspnea and strokes, respectively. Elderly woman exhibited a greater association with the diagnosis of bronchial asthma, and more diseases associated with lung disease. Physical inactivity, difficulty walking, and a history of alcohol consumption and smoking are more associated with men, while depression, the presence of allergies, regular physical activity and osteoporosis are more associated with women. Thus, the results demonstrate that these individuals have specific characteristics. AU

Resumo Introdução: Pneumopatias são definidas como grupo de doenças respiratórias. Centros de fisioterapia surgem como tratamento convencional que contribui para prevenir e tratar variadas condições pulmonares. Objetivo: Caracterizar idosos com pneumopatias admitidos para reabilitação pulmonar. Métodos: A amostra foi composta por 84 pacientes admitidos para reabilitação pulmonar no departamento de fisioterapia cardiopulmonar de uma clínica escola. Pacientes com diagnóstico de doença pulmonar e idade ≥60 anos foram incluídos no estudo. As seguintes variáveis foram analisadas: sexo, idade, estado civil, profissão, diagnóstico médico, queixa principal, doença associada, e fatores de risco cardiovascular. Resultados: A pneumopatia mais comum foi doença pulmonar obstrutiva crônica (DPOC) (26,2%). Mulheres mostraram maior associação com asma [Odds Ratio (OR)=5,875; p=0,010]. Dispneia foi a queixa principal mais prevalente na população (50%). Entre as queixas principais, dificuldade de deambular foi mais associada com homens (OR=2,85; p=0,055). Acidente vascular cerebral (AVC) foi a doença principal mais associada com pneumopatias (12,1%). Mulheres tiveram maior associação com outras doenças (OR=5,34, p=0,068), especialmente, quando apresentaram mais que dois quadros simultaneamente com a pneumopatia (OR=2,32, p=0,041). Entre os fatores de risco, a inatividade física (OR=3,33), o consumo de álcool (OR=0,046) e o histórico de tabagismo (OR=3,00) foram significativamente associados ao sexo masculino, enquanto depressão (OR=5,67) ao feminino. Mulheres apresentaram 3,28 mais associação entre alergias e pneumopatias que os homens (p=0,013). A prática de atividade física foi mais associada com o sexo feminino (OR=3,89; p=0,03). Osteoporose foi mais prevalente em mulheres idosas com doença pulmonar (OR=10,75; p<0,0001), e também significativamente, enquanto associada ao histórico de tabagismo (OR=4,31; p=0,009). Conclusão: O diagnóstico, a queixa principal e a doença associada mais frequentes foram DPOC, dispneia e AVC, respectivamente. Idosas apresentam maior associação com diagnóstico de asma brônquica e mais doenças associadas à pneumopatia. Sedentarismo, dificuldade de deambular, etilismo e histórico de tabagismo são mais associados ao sexo masculino, enquanto que depressão, presença de alergias, prática de atividade física e osteoporose, ao feminino. Assim, os resultados demonstram que esses idosos apresentam características específicas. AU

Prognosis Factors in Patients with Spinal Cord Trauma / Fatores de prognóstico em pacientes com trauma raquimedular

Objective Analyze the predictors of prognosis in patients with spinal cord trauma (SCT) in a tertiary hospital. Method Study prospective with 321 patients. The analysis focused on patient-related data, cause of accident, anatomical distribution, neurologic status, associated injuries, length of hospital stay, and in-hospital complications/mortality. Results The SCT was more common in men, but women older than 50 years presented a higher risk than men of the same age. Automobile accidents, motorcycle accidents, and gunshots resulted in more injuries associated. The cervical spine involvement was directly related to an increase in the number of associated injuries, complications, and mortality. Already, the neurologic status ASIA-A was associated with an increase in the number of complications, length of stay, and mortality. Conclusion The predictive factors of prognosis in these patients included age, sex, cause of injury, anatomic distribution, and neurologic status.

Objetivo Analisar os preditores de prognóstico em pacientes vítimas de trauma raquimedular (TRM) em um hospital terciário. Método Estudo prospectivo com 321 pacientes. A análise foi direcionada aos dados relacionados aos pacientes, causa do acidente, distribuição anatômica, status neurológico, lesões associadas, tempo de permanência hospitalar e complicações e mortalidade no hospital. Resultados O TRM foi mais comum em homens, mas mulheres com idade superior a 50 anos apresentaram mais risco que homens da mesma faixa etária. Ferimento por arma de fogo, acidentes automobilísticos e de motocicleta resultaram em maior número de lesões associadas. O trauma na coluna cervical foi diretamente relacionado

Analysis of patients with spinal cord trauma associated with traumatic brain injury / Análise de pacientes com trauma raquimedular associado a traumatismo cranioencefálico / Análisis de los pacientes con traumatismos vertebrales asociados con traumatismos encefálicos

Objective: Characterize victims of spinal cord injury (SCI) associated with traumatic brain injury (TBI) and risk factors. Methods: Study conducted with 52 victims of SCI associated with TBI. The variables studied were: sex; age; marital status; occupation; educational level; religion; etiology and the lesion area; neurological condition by the ASIA scale; associated injuries and potential risk factors. Results: The male (85%), aged between 21-30 years (25%), civil status stable union (56%), low level of education (69%) and the Roman Catholic religion (77%) presented the greater number of victims. Motor vehicle accidents (58%) were the main etiology. The cervical segment had higher injury risk (RR=3.48, p<0.0001). The neurological status ASIA-E (52%), the syndromic neck pain (35%) and the rate of mild TBI (65%) were the most frequent. Complications occurred in 13 patients with increased frequency of pneumonia (62%). The length of hospital stay was significantly higher (20±28 days) and 17% of patients died. Men (RR=2.14, p=0.028) and individuals exposed to motor vehicle accidents (RR=1.91, p=0.022) showed a higher risk of these lesions concurrently. Moreover, these patients had 2.48 (p<0.01) higher risk of death than victims of SCI alone. Conclusion: The SCI associated with TBI was more frequent in men, young adults, and individuals exposed to motor vehicle accidents. The cervical spine is more likely to be affected. Furthermore, ...

Objetivo: Caracterizar vítimas de trauma raquimedular (TRM) associado a traumatismo cranioencefálico (TCE) e fatores de risco. Métodos: Estudo realizado com 52 vítimas de TRM associado a TCE. Foram estudadas as variáveis: sexo; idade; estado civil; profissão; escolaridade; religião; etiologia e região do TRM; condição neurológica pela escala da ASIA; lesões associadas e fatores de risco em potencial. Resultados: O sexo masculino (85%), a faixa etária entre 21-30 anos (25%), o estado civil de união estável (56%), o baixo nível de escolaridade (69%) e a religião Católica Apostólica Romana (77%) apresentaram um maior número de vítimas. O acidente automobilístico (58%) foi a principal etiologia. O segmento cervical teve maior risco de lesão (RR=3,48; p<0,0001). O estado neurológico ASIA-E (52%), o quadro sindrômico de cervicalgia (35%) e o índice de TCE leve (65%) foram os mais frequentes. As complicações atingiram 13 pacientes, sendo pneumonia a de maior frequência (62%). O tempo de internação foi significativamente maior (20 ± 28 dias), e 17% dos pacientes foram a óbito. Os homens (RR=2,14; p=0,028) e indivíduos expostos a acidentes com veículo automotor (RR=1,91; p=0,022) apresentaram maior risco de sofrer essas lesões ...

Objetivo: Caracterizar las víctimas de traumatismos vertebrales (TV) asociados con traumatismos encefálicos (TE) y los factores de riesgo. Métodos: Estudio realizado con 52 víctimas de TV asociados con TE. Se estudiaron las siguientes variables: sexo; edad; estado civil; profesión; educación; religión; etiología y el área de la lesión; condición neurológica por la escala ASIA; lesiones asociadas y factores de riesgo potenciales. Resultados: El varón (85%), con edades comprendidas entre 21-30 años (25%), estado civil de relación estable (56%), bajo nivel de educación (69%) y la religión católica (77%) presentaron un mayor número de víctimas. Los accidentes de tráfico (58%) fueron la principal etiología. El segmento cervical presentó mayor riesgo de lesión (RR = 3,48, p<0,0001). El estado neurológico ASIA-E (52%), cuadro sindrómico de dolor del cuello (35%) y la tasa de TE leve (65%) fueron las más frecuentes. Las complicaciones ocurrieron en 13 pacientes, con una mayor frecuencia de la neumonía (62%). La estancia hospitalaria fue significativamente mayor (20 ± 28 días) y el 17% de los pacientes murió. Los hombres (RR=2,14, p=0,028) y los individuos expuestos a accidentes de tráfico (RR = 1,91, p=0,022) mostraron un mayor riesgo de estas lesiones ...

Efeito da estimulação abdominal sobre o contato plantar na lesão encefálica adquirida / Effects of abdominal stimulation on plantar contact in case of the acquired brain injury

Objetivo: Verificar a influência da estimulação dos músculos abdominais em pacientes com LEA sobre o contato plantar. Método: Participaram oito indivíduos com idade média de 46±15,9 anos. Para avaliação de pressão plantar, utilizou-se um baropodômetro, com coleta antes e após a estimulação abdominal, a qual foi realizada com os pacientes posicionados no divã com apoio na região sacral/quadril e joelhos flexionados em 90°, e pés, mãos e tronco superior sem apoio. Estes músculos foram estimulados a realizar contração por desequilíbrio provocado pela diminuição na base de suporte (apoiados somente em sacro). Assim, realizou-se contração isométrica para o posicionamento, intercalada por contrações isotônicas de curta amplitude, para recuperação do equilíbrio. Resultados: Na distribuição de pressão plantar, observou-se que o retropé e mediopé apresentam maior e menor pico de pressão, respectivamente (p<0,05). Houve diminuição do pico de pressão bilateral, especialmente no pé direito (p=0,05), e aumento da área de contato plantar dos pacientes, principalmente no pé esquerdo (p=0,03). Conclusão: A estimulação aguda da musculatura abdominal influenciou na área de contato e nos valores de pico de pressão plantar, mesmo com a amostra heterogênea estudada.

Objective: To evaluated the influence of abdominal stimulation in patients with acquired brain injury on plantar pressure distribution. Method: Eight individuals aged 46±15.9 years were evaluated. Analysis of plantar pressure distribution was performed through a baropodometer. The collection was performed before and after abdominal stimulation. The abdominal stimulation was performed with the patient positioned on the divan with support in the region sacral / hip and knees flexed at approximately 90º, and feet, hands and upper trunk without support. The contraction of these muscles was obtained through the loss of balance caused by the decrease of the support base (patients supported only by the sacrum. Thus, isometric contraction was performed for positioning, alternating with isotonic contractions of short duration to recover balance. Results: In plantar pressure distribution, the hindfoot and midfoot regions showed, respectively, higher and lower peak pressures (p<0.05). Also, there was less pressure peak bilaterally, especially in the right foot (p=0.05), and an increase in plantar contact surface in the patients, mainly in the left foot (p=0.03). Conclusion: We conclude that acute stimulation of the abdominal muscles influences the contact surface and the values of peak plantar pressure, even with a heterogeneous sample studied.

Predictors of clinical complications in patients with spinomedullary injury / Preditores de complicações clínicas em pacientes com trauma raquimedular / Predictores de complicaciones en pacientes con trauma raquimedular

Objective: To analyze individuals with spinal cord injury who developed secondary clinical complications, and the variables that can influence the prognosis. Methods: A prospective study of 321 patients with spinal cord injury. The variables were collected: age, sex, cause of the accident, anatomical distribution, neurological status, associated injuries, in-hospital complications, and mortality only in patients who developed complications. Results: A total of 72 patients were analyzed (85% male) with a mean age of 44.72±19.19 years. The individuals with spinal cord injury who developed clinical complications were mostly male, over 50 years of age, and the main cause was accidental falls. These patients had longer hospitalization times and a higher risk of progressing to death. Pneumonia was the main clinical complication. With regard to the variables that can influence the prognosis of these patients, it was observed that spinal cord injury to the cervical segment with syndromic quadriplegia, and neurological status ASIA-A, have a higher risk of developing pneumonia, the most common complication, as well as increased mortality. Conclusion: Clinical complications secondary to spinal cord injury are influenced by demographic factors, as well as characteristics of the injury contributing to an increase in mortality.

Objetivo: Analisar pacientes de um hospital terciário com trauma raquimedular que evoluíram com complicações clínicas intra-hospitalares, bem como as variáveis que podem interferir no prognóstico. Métodos: Estudo prospectivo de 321 pacientes vítimas de trauma raquimedular, que coletou dados sobre as seguintes variáveis: idade, sexo, etiologia do acidente, distribuição anatômica, estado neurológico, lesões associadas, complicações clínicas e mortalidade. Foram analisados apenas os pacientes que evoluíram com complicações. Resultados: Foram analisados 72 pacientes (85% do sexo masculino), com média de idade de 44,72±19,19 anos. Esses indivíduos com trauma raquimedular evoluíram com complicações clínicas intra-hospitalares, sendo a maioria do sexo masculino e com idade superior a 50 anos, sendo a principal causa a queda acidental. Além disso, esses pacientes apresentaram maior tempo de permanência hospitalar e risco de evoluir para o óbito. A pneumonia foi a principal complicação clínica. Com relação às variáveis que podem interferir no prognóstico desses pacientes, observa-se que o trauma raquimedular no segmento cervical com quadro sindrômico de tetraplegia e o estado neurológico ASIA-A apresenta maior risco de desenvolver complicações clínicas, sendo a pneumonia a mais frequente, assim como maior risco de aumentar a mortalidade. Conclusão: As complicações clínicas secundárias ao trauma raquimedular são influenciadas por fatores demográficos, assim como por características relacionadas com a lesão, interferindo no aumento da mortalidade.

Objetivo: Analizar los pacientes en un hospital de tercer nivel con lesión de la médula espinal que tuvieron complicaciones clínicas, así como las variables que pueden influir en el pronóstico. Métodos: Estudio prospectivo de 321 pacientes con lesiones de la médula espinal, que recopiló datos sobre las siguientes variables: edad, sexo, causa del accidente, distribución anatómica, estado neurológico, lesiones asociadas, complicaciones clínicas y mortalidad. Sólo se analizaron los pacientes que desarrollaron complicaciones. Resultados: Se analizaron 72 pacientes (85% varones) con una edad media de 44,72±19,19 años. Aquellos individuos con lesión de la médula espinal progresaron con complicaciones clínicas intrahospitalarias, en su mayoría varones y mayores de 50 años, siendo la caída accidental la principal causa. Además, estos pacientes tenían una estancia hospitalaria más prolongada y riesgo de progresar a la muerte. La neumonía fue la principal complicación clínica. En cuanto a las variables que pueden influir en el pronóstico de estos pacientes, se observa que la lesión de la médula espinal en el segmento cervical con cuadro sindrómico de tetraplejía y el estado neurológico ASIA-A aporta un mayor riesgo de desarrollar complicaciones clínicas, siendo la neumonía la más frecuente, así como mayor riesgo de aumento de la mortalidad. Conclusión: Las complicaciones clínicas secundarias a la lesión de la médula espinal se ven afectadas por factores demográficos, así como por las características relacionadas con la lesión, que influyen en el aumento de la mortalidad.

Reabilitação Vestibular em portadores de Vertigem Posicional Paroxística Benigna / Vestibular rehabilitation in patients with benign paroxysmal positional vertigo

OBJETIVO: verificar, por meio do questionário handicap de tontura, o efeito de um protocolo de Reabilitação Vestibular (RV) em portadores de Vertigem Posicional Paroxística Benigna (VPPB) sete dias após primeira intervenção e seis meses após a segunda intervenção. MÉTODO: pacientes submetidos à confirmação diagnóstica de VPPB pela positividade da manobra Dix-Hallpike foram avaliados (coleta) pelo questionário Dizziness Handicap Inventory - brasileiro (DHI-brasileiro), antes da primeira intervenção, após a segunda (intervalo de sete dias) e seis meses após a segunda intervenção. As intervenções constavam de relaxamento cervical, manobra de Epley e restrições posturais e foram aplicadas logo após a primeira avaliação e antes da segunda avaliação, com intervalo de sete dias. Os resultados obtidos foram submetidos à análise estatística. RESULTADOS: nove mulheres com média de 63 anos (desvio padrão 4,6) fizeram parte da amostra. Foram encontradas as seguintes pontuações no DHI-brasileiro: Aspecto Físico - apresentou média na coleta 1 de 2,6a(±0,17); coleta 2 de 0,82b (±0,24); coleta 3 de 1,43b(±0,43) com p<0,05; Funcional - apresentou média na coleta 1 de 1,73(±0,21); coleta 2 de 0,93(±0,27); coleta 3 de 1,28 (±0,39); Emocional - apresentou média na coleta 1 de 1,03(±0,24); coleta 2 de 0,49 (±0,23); coleta 3 de 0,82 (±0,36). CONCLUSÃO: a VPPB quando avaliada pelo DHI-brasileiro, traz prejuízos aos portadores em alguns aspectos e a reabilitação vestibular, com a aplicação do protocolo proposto, promoveu melhora na qualidade de vida, com maior redução dos sintomas sete dias após a primeira intervenção. Após seis meses houve certa redução do quadro de melhora, porém este ainda se manteve em melhores condições quando comparado à primeira coleta.

PURPOSE: to evaluate, by means of the dizziness handicap questionnaire, the effect of a Vestibular Rehabilitation (VR) protocol in patients with benign paroxysmal positional vertigo (BPPV), seven days after the first intervention and six months after the second intervention. METHOD: patients undergoing BPPV diagnosis confirmation by a positive Dix-Hallpike maneuver were assessed (collection) by the Dizziness Handicap Inventory - Brazilian (DHI-Brazilian) before the first intervention, after the second (seven day interval) and six months after the second one. The interventions consisted of cervical relaxation, Epley and postural restrictions were applied after the first assessment and before the second evaluation, with an interval of seven days. The results were statistically analyzed. RESULTS: nine women with an average 63-year old (standard deviation 4.6). Were found in DHI-Brazilian aspects: Physical - the collection 1 a mean of 2.6a(±0.17); collection 2 of 0.82b(±0.24); collection 3 of 1.43b(±0.43) with p<0.05; Functional - the collection 1 a mean of 1.73(±0 21); collection 2 of 0.93(±0.27); collection 3 of 1.28(±0.39); Emotional - the collection 1 a mean of 1.03(±0.24); collection 2 of 0.49(±0.23); collection 3 of 0.82(±0.36). CONCLUSION: the BPPV, when evaluated by the DHI-Brazilian, harms the patients in some aspects and vestibular rehabilitation, with the application of the proposed protocol, it promoted improved quality of life, with greater reduction in symptoms, seven days after the first intervention. After six months there was some reduction in the status of improvements, but it still remained in better condition comparing with the first collection.

Diagnóstico por imagem em paciente com traumatismo da coluna vertebral / Image diagnosis of patients submitted to spinal injury

O traumatismo raquimedular (TRM) pode ser definido como qualquer agressão que acarrete lesão anatômica ou funcional doselementos neurais (medula espinhal, raízes nervosas), dentro do canal vertebral com ou sem fraturas e / ou deslocamento dacoluna vertebral, resultando em mudança, seja ela permanente ou temporária, na sua função motora, sensitiva e autonômica. Odiagnóstico das lesões traumáticas de coluna vertebral é o evento inicial e fundamental para o sucesso terapêutico. Dentre asmais utilizadas estão a radiografia simples, a tomografia computadorizada (TC) e a ressonância magnética (RM). A abordageminicial do paciente com suspeita de traumatismo de coluna vertebral deve ser feita através do estudo com radiografia simples,que consiste em método disponível e rápido. A TC é capaz de diagnosticar fraturas ocultas à radiografia simples, fornecendoinformações adicionais para avaliação mais detalhada da fratura e elaboração do seu tratamento e definindo melhor oscontornos ósseos. Já a RM pode visualizar com mais vantagem o canal espinhal e o grau e a extensão de tecidos moles, comonas lesões medulares, vasculares, discos e os hematomas epidurais. Assim, a escolha do exame no momento da avaliação inicialdo paciente irá influenciar em melhor prognóstico devendo ser realizada com autonomia e segurança.

Perfil epidemiológico de pacientes com traumatismo raquimedular atendidos em hospital terciário / Epidemiological profile of patients suffering from cord spinal injury treated in tertiary hospital / Perfil epidemiológico de pacientes con trauma espinal tratados en el hospital de tercer nivel

OBJETIVO: Avaliar o perfil epidemiológico de pacientes com traumatismo raquimedular atendidos em hospital terciário. MÉTODOS: Estudo descritivo, transversal, prospectivo, com 321 pacientes vítimas de traumatismo raquimedular, realizado de janeiro de 2008 a junho de 2012. Foram estudadas as variáveis: sexo; idade; estado civil; profissão; escolaridade; religião; procedência; etiologia, morfologia e região da lesão; condição neurológica pela escala da ASIA e lesões associadas. RESULTADOS: Amostra constituída por 72% pacientes do sexo masculino e 28% do feminino, prevalência da faixa etária de 21 a 30 anos. Os estados civis mais frequentes foram união estável (46,8%) e solteiros (41,7%). O nível de escolaridade foi ensino fundamental incompleto (57%) e completo (17,8%). As causas mais frequentes foram acidentes automobilísticos (38,9%) e queda (27,4%). A lesão mais presente foi fratura explosão (23,7%), as regiões mais afetadas foram cervical subaxial (41,7%) e transição toracolombar (30,5%). A lesão associada mais frequente foi traumatismo cranioencefálico (TCE) (28,2%). O estado neurológico mais observado na internação/alta foi ASIA-E. Ocorreram 25 óbitos (7,8%), sendo que 76% com lesão na região cervical foram estratificados com ASIA-A, e 68% tiveram complicações respiratórias. CONCLUSÃO: O trauma raquimedular acometeu mais adultos jovens do sexo masculino com união estável e baixo nível de escolaridade. A causa mais frequente foi acidente automobilístico, o tipo de lesão foi fratura explosão e a região cervical a mais acometida. A condição neurológica mais presente foi ASIA-E, o TCE foi a lesão associada mais frequente e a maior gravidade pela classificação da ASIA nos casos de envolvimento cervical aumentou o risco de complicações respiratórias e morbidade e mortalidade.

OBJECTIVE: Evaluate the epidemiological profile of patients with spinal cord injury (SCI) treated in a tertiary hospital. METHODS: Descriptive, transversal and prospective study with 321 patients, conducted from January/2009 to June/2012. Variables studied: sex; age; marital status; profession; schooling; religion; origin; etiology, morphology and region of the lesion; neurological status by ASIA and the associated lesions. RESULTS: The sample consisted of 72% males and 28% females, the prevalent age group was 21-30 years. The most common marital status was married (46.8%) and singles (41.7%). The educational level was incomplete (57%) and complete (17.8%) elementary school. The most common causes were traffic accidents (38.9%) and falls (27.4%). The most common injury was burst fracture (23.7%), the most affected areas were subaxial cervical (41.7%) and thoracolumbar transition (30.5%). The most frequent associated injury was traumatic brain injury (TBI) (28.2%). The most frequent neurological condition at admission/discharge was ASIA-E. There were 25 deaths (7.8%) and 76% with lesion in the cervical region were classified with ASIA-A and 68% had respiratory complications. CONCLUSION: SCI affected more married young adult males with low level of education. The most common cause was motor vehicle accident, the type of injury was burst fracture and the cervical region was the most affected. The most common neurological status was ASIA-E and TBI was the most frequente associated injury and the greater severity by ASIA in cases with the cervical involvement increased the risk of respiratory complications and morbidity and mortality.

OBJETIVO: Evaluar las características epidemiológicas de los pacientes con lesión medular atendidos en hospital de tercer nivel. MÉTODOS: Estudio descriptivo, transversal, prospectivo con 321 pacientes que sufrieron lesiones de la médula espinal, realizado desde enero del 2008 hasta junio del 2012. Se estudiaron las variables: sexo; edad; estado civil; profesión; escolarización; religión; origen; etiología, la morfología y la región del lesión; estado neurológico por la escala ASIA y lesiones asociadas. RESULTADOS: La muestra se compone de 72% de hombres y 28% de mujeres, con prevalencia del grupo de edad de 21-30 años. el estado civil más frequente fue casados (46.8%) y solteros (41.7%). El nivel de escolaridad fue educación primaria incompleta (57%) y completa (17,8%). Las causas más frecuentes fueron los accidentes de autos (38.9%) y las caídas (27,4%). La lesión más común fue la fractura por estallido (23,7%), la región más afectada fue la subaxial cervical (41.7%) y la transición lumbar torácica (30.5%). La lesión asociada más frecuente fue la cerebral traumática (LCT) (28.2%). El estado neurológico más encontrado en la admisión/alta fue ASIA-E. Hubo 25 muertes (7.8%), 76% de lesiones en la región cervical fueron estratificados como ASIA-A, y el 68% tuvo complicaciones respiratorias. CONCLUSIÓN: La lesión de la médula espinal afecta más jóvenes varones casados y con bajo nivel de educación. La causa más común fue el accidente de auto, el tipo de lesión fue fractura por estallido y la región cervical fue la más afectada. El estado neurológico más común fue ASIA-E y las LCT asociadas fueron las más frecuentes y más graves en ASIA. La mayor gravedad por la clasificación de ASIA en casos de afectación cervical aumentó el riesgo de complicaciones respiratorias y la morbi-mortalidad.